Otsuka Mitusya, Tojo Naoki, Hayashi Atsushi
Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
Int Ophthalmol. 2023 Oct;43(10):3471-3477. doi: 10.1007/s10792-023-02752-9. Epub 2023 Jun 5.
Previously, we reported that the Ex-press® shunt (EXP) was associated with more rapid reduction in corneal endothelial cells when inserted into the cornea rather than the trabecular meshwork (TM). We compared the reduction rate of corneal endothelial cells between the corneal insertion group and TM insertion group.
This was a retrospective study. We included patients who had undergone EXP surgery and were followed for > 5 years. We analyzed the corneal endothelial cell density (ECD) before and after EXP implantation.
We included 25 patients in the corneal insertion group and 53 patients in the TM insertion group. One patient in the corneal insertion group developed bullous keratopathy. The ECD decreased significantly more rapidly in the corneal insertion group (p < 0.0001), in whom the mean ECD decreased from 2227 ± 443 to 1415 ± 573 cells/mm at 5 years with a mean 5-year survival rate of 64.9 ± 21.9%. By contrast, in the TM insertion group, the mean ECD decreased from 2356 ± 364 to 2124 ± 579 cells/mm at 5 years, and the mean 5-year survival rate was 89.3 ± 18.0%. The decrease rate of ECD was calculated as 8.3%/year in the corneal insertion group and 2.2%/year in the TM insertion group.
Insertion into cornea is a risk factor for rapid ECD loss. The EXP should be inserted into the TM to preserve the corneal endothelial cells.
此前，我们报道过，当Express®分流器（EXP）植入角膜而非小梁网（TM）时，角膜内皮细胞减少得更快。我们比较了角膜植入组和小梁网植入组角膜内皮细胞的减少率。
这是一项回顾性研究。我们纳入了接受EXP手术且随访时间超过5年的患者。我们分析了EXP植入前后的角膜内皮细胞密度（ECD）。
我们纳入了25例角膜植入组患者和53例小梁网植入组患者。角膜植入组有1例患者发生了大疱性角膜病变。角膜植入组的ECD下降明显更快（p<0.0001），5年时平均ECD从2227±443降至1415±573个细胞/mm²，平均5年生存率为64.9±21.9%。相比之下，小梁网植入组5年时平均ECD从2356±364降至2124±579个细胞/mm²，平均5年生存率为89.3±18.0%。角膜植入组ECD的下降率计算为每年8.3%，小梁网植入组为每年2.
